by Kelly S. Kennedy, @KellySKennedy, USA TODAY

by Kelly S. Kennedy, @KellySKennedy, USA TODAY

WASHINGTON - The federal government Wednesday kicks off an effort to raise awareness about the most controversial part of the health care law - the requirement that the uninsured buy health care insurance.

Wednesday morning, the Department of Health and Human Services plans to relaunch its website to try to draw in the millions of uninsured people needed to make the health care law work when open enrollment in state and federal health care exchanges begins in October.

"There are millions of Americans who need to be able to find and use health coverage," said Jason Young, deputy assistant secretary for public affairs at HHS. The restarted website marks the beginning of a "full-throttle" effort to market the federal health care exchange, he said.

As many as 43 million people will be required to buy a bronze, silver, gold or platinum plan from private insurers based on upfront costs vs. out-of-pocket costs, beginning in January 2014. Failure to buy the insurance, offered in so-called health exchanges, is punishable by fines up to $95 for adults in 2014. That increases to $325 in 2015, and $695 in 2016. Tax credits will be offered to help families within 400% of the poverty level afford insurance.

The exchanges face huge hurdles, including uninformed consumers, past frustration with insurance companies and a perception among many that the government should not be involved in health care. Even as the exchanges launch, Republican governors in some states continue to oppose the law and creating state exchanges.

And the Congressional Budget Office based budget estimates on the expectation that 25 million people will enroll in the exchanges by 2022. However, the government's last push for insurance enrollment, for the Pre-existing Condition Insurance Plan, brought in just 82,000 people out of 375,000 Americans who were expected to enroll.

"What we need now is an all-hands effort," said Ron Pollack, chairman of the newly formed Enroll America, a group of 50 pharmaceutical companies, health care providers and advocacy organizations that plans to raise and spend $100 million to promote federal and state exchanges.

Enroll America announced Tuesday a massive, campaign-style effort to ensure that those who can be helped by health coverage understand what exchanges are, how much insurance will cost and the benefits it will provide. Some members of the new group, including insurance giant Aetna, initially lobbied against the health care law.

Now that the law has survived the presidential election and Supreme Court review, it's important for both business and the government that people get health insurance, Pollack said. The exchanges need younger Americans who tend to believe they won't need medical help to buy insurance to spread the costs among the insured population, he said.

"For (providers), it makes a whole lot of sense that people be insured so that they get paid," Pollack said. "It makes good sense from a purely business perspective."

A health care exchange is a website that allows consumers to easily compare benefits and costs of health insurance plans. The plans become available in January 2014, when the Affordable Care Act also requires insurers to provide coverage to all Americans, no matter their health status.

So far, 19 states and the District of Columbia have been conditionally approved to run exchanges. There will also be a federal exchange for people who live in states without one. The exchanges are for individuals and employees who work for companies with 100 or fewer workers.

Also Wednesday, the government will announce a new name for the federal exchange as part of its marketing effort: the "Health Insurance Marketplace."

"We felt simpler was better," Young said.

The federal website, healthcare.gov, attracts 25 million hits a year now, he said. Visitors can learn how health insurance works, what benefits they might want when open enrollment begins, and if they will be eligible for subsidies to help pay for insurance.

"On Oct. 1, we will be ready to go," Young said.

Pollack said many people would probably need in-person help to figure out what health plan to get simply because they've never had insurance before. Others have been told they couldn't have insurance because of a pre-existing condition. And others got lost in the fine print and gave up before purchasing insurance.

"There is some skepticism in addition to a lack of knowledge," he said. "The campaign will help with that."

Two states that already have exchanges - Utah and Massachusetts - have given federal officials examples to follow.

Utah began its health exchange for small businesses in 2008, but didn't have to do much marketing for the launch, said Steve Gooch, the exchange's marketing director. Instead, the brokers that offered insurance to small businesses just included the exchange as an option when they talked to their clients.

The state changed its marketing as it began offering exchange options to individual consumers, Gooch said. It changed the exchange's name and launched an advertising campaign.

Massachusetts will emphasize provisions in the law, said Stephanie Nichols, the state exchange's marketing director. Now, 98% of Massachusetts adults have health insurance, she said, and the state will use social media more aggressively for its federal campaign. That will include a new website that tells people instantly if they are eligible for federal tax credits or other financial help.

"We definitely will be informing consumers about the benefits of the advent of national health care reform," Nichols said.